Nicotine patches, gums and nasal sprays prescribed to stop people from smoking may also help them cut down on booze, a new study suggests.
Originally designed as the control arm of a clinical trial testing whether anti-smoking prescription drugs would help people quit booze, these high street remedies performed just as well.
After three months, participants reduced their alcohol consumption regardless of whether they were given nicotine replacement therapy or prescription drugs – varenicline or cytisine.
The researchers say these medications could all play an important role in reducing alcohol and smoking at the same time.
“Risky drinking and smoking frequently co-occur and they both threaten health by increasing risk of cardiovascular disease, cancer and other important health outcomes.”
Along with colleagues from Boston Medical Centre and First Pavlov State Medical University, St Petersburg, Dr. Tindle studied 400 people living with HIV in Russia.
Researchers are increasingly focusing on treating other diseases in people with HIV because there are now such effective treatments for the virus.
They recruited volunteers who self-identified as drinking and smoking risky amounts and followed them for a year.
The researchers wanted participants who had five or more heavy drinking days a month (defined as having five or more drinks in one day for men and four or more for women) and who smoked five or more cigarettes a day.
Medications were placebo-controlled so neither participants nor investigators knew who had been assigned which medication.
Publishing their results in JAMA Network Open, the team found that after three months, alcohol consumption decreased regardless of which anti-smoking treatment participants were given.
One of the lead researchers Dr. Matthew Freiberg, of VUMC, said: “It was gratifying to see high-risk research participants being included in NIH-funded research.
“They are not only living with HIV but also have a high burden of hepatitis, multi-substance use and mental health issues.
“Such participants are often excluded from drug trials. If a medication as simple as nicotine replacement could help them that would be a win.”
Nicotine replacement therapy – the patches, gums and sprays – has long been available on the UK’s high streets at relatively low cost but has not been used to help people cut down on booze.
Cytisine has been available in Eastern Europe since the 1960s and varenicline was withdrawn from the NHS as well as across Europe because of an impurity found in the medicine.
Dr. Jeffrey Samet of Boston University, who also worked on the study, said: “Another important observation in our posthoc analysis was that rates of alcohol consumption were lower and rates of alcohol abstinence were higher among the people who quit smoking as compared to those who continued to smoke.
“These results need further study to understand if findings were due to the medications directly, quitting smoking, or both.”
Dr. Tindley also said that there is much still to learn about how the study drugs – termed nicotinic acetylcholine receptor agonists – may work to reduce alcohol consumption, but that the work has shown that these drugs target receptors in the nervous system which encourage voluntary abstinence.
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